船员屈指肌腱损伤的治疗

目的探讨船员屈指肌腱损伤的特点和治疗方法。方法对本院收治的５２例船员屈指肌腱损伤临床资料进行总结并着重对治疗效果进行分析。结果本组Ⅰ期修复４３例１６８条，Ⅱ期修复９例２４条。术中用套圈缝合法或改良Ｋｅｓｓｌｅｒ法缝接肌腱，Ⅱ期行粘连肌腱松解术８例２５条，术后２４小时开始功能锻炼。治疗效果经对４３例１４６条随访３个月～３年（平均１年６个月），根据ＴＡＭ疗效标准评定为：锐割伤５７条中，优４７条，良８条，中２条，优良率为９６．５％；缆绳绞轧伤３６条中，良２１条，中９条，差６条，优良率为５８．３％；压榨断开伤５３条中，优２９条，良１６条，中６条，差２条，优良率为８４．９％。结论屈指肌腱损伤疗效与损伤类型关系密切。锐器切割伤疗效最佳，缆绳绞轧伤最差。对缆绳绞轧伤应积极创造条件，采取相应措施，以提高其疗效

The treatment of digital flexor tendon injuries in the seamen(report of 52 cases)

Objective To investigate the pathogenosis and treatment of digital flexor tendon injuries in the seamen.Methods The cause, treatment and result fifty two cases of digital flexor tendon injuries in the seamen were retrospectively analyed.Results The injuries of the 52 cases can be classified into three types: sharp cut injury, hawser wringing injury and press break injury. The former two types were treated chiefly by primary repair. The later one type could also be treated by primary repair if the trauma is not severe. Tsuge method or modified Kessler method were used in the tendon conection operation and hand function rehabilitation exercises were started 24 h later after the operation. Among all the 52 cases, primary repair of 168 flexor tendons were done in 43 cases, secondary repair of 24 flexor tendons were done in 9 cases and secondary adhesiotomy of 25 flexor tendons were done in 8 cases. According to the result of follow up of 1.5 years in average of 146 tendons in 43 cases, using the TAM therapeutic effect criterion, there were 47 excellent, 8 good and 2 fair with a 96.5% excellent and good rate for the 57 tendons of the sharp cut type injury, 29 excellent, 16 good, 6 fair and 2 poor with a 84.9% excellent and good rate for the 53 tendons of the press break type injury, and 21 good, 9 fair and 6 poor with a 58.3% excellent and good rate for the 36 tendons of the hawser wringing type injury.Conclusions The therapeutic effect of digital flexor tendon injuries in the seamen was closely related to the type of its injury. It is better in sharp cut type and worse in hawser wringing type, there fore, great effort should be made to improve the treatment of hawser wringing injured tendons.